Paternalism and Competent Patient Choice in the Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People

In 2016 physicians in Ontario will be granted the authority to refer patients with gender dysphoria for sex reassignment surgery. In order to be granted this authority physicians must be trained in the World Professional Association for Transgender Health’s Standards of Care, which outlines healthcare procedures for the treatment of gender dysphoria and provides background information concerning transgender health. The Standards of Care require that patients undergo a process of 12 months of continuous living in a gender role that is congruent with their gender identity prior to being given access to sex reassignment surgery. While this requirement can sometimes be helpful it can also cause more harm than benefit. This paper argues that the requirement is strongly paternalistic in its current form and should no longer be mandatory in most cases.

The Dynamic Process of Development through Sport

This article presents a global vision for sport through a new framework that incorporates the elements necessary for a developmentally sound approach to youth sport involvement. This framework proposes that youth sport involvement includes three basic elements: (1) taking part in activities (what), while creating relationships with others (who), in a specific setting (where). When these three elements positively interact, it creates a context that, when repeated on a regular basis, leads to changes in the personal assets of the participants. Changes in individuals’ personal assets, such as Competence, Confidence, Connection, and Character (4 C’s), have long been associated with positive sport experiences, which in turn lead to long-term outcomes, including continued sport Participation, higher levels of Performance in sport, and Personal development through sport (3 P’s). Research linking the three basic elements of youth sport (activities, relationships, and settings) to positive changes in personal assets (4 C’s) and long-term outcomes (3 P’s) are discussed and the Personal Assets Framework is presented